Including a strong mentoring component, the proposed NIDA K24 award will provide support for Wilson M. Compton, M.D. to enhance a program of research into Psychiatric Comorbidity Among Drug Abusers. The overall goal of the proposed research is to increase the identification and improve the treatment of adults with comorbid substance and non-substance psychiatric disorders. This goal will be addressed by conducting methodological work to improve the assessment of psychiatric disorders among substance abusers through funding provided by this K24 award and through ongoing work by the team at Washington University (WU). Furthermore, as part of a pending grant proposal, structured psychiatric assessments will be conducted on 1000 adult admissions to the Chestnut Health Systems (CHS) outpatient drug treatment programs in Madison County, Illinois. Patients will be screened for co-existing psychiatric disorders and when current depressive disorders are detected, they will be randomized to an experimental "psychiatric case management intervention group" or a "usual care" group. The experimental subjects will be assigned to a clinical case manager who will follow an established protocol for motivating patients to start and follow up with psychiatric care. All experimental and control group subjects will be followed up at 3 and 12 months after the baseline assessment to determine outcomes using CHS records, State records, in person interviews, and urine drug testing. The specific aims of this study focus on both research and programmatic goals. The research aims are: 1) to improve the detection of psychiatric disorders among substance abusers; and 2) to determine the impact of providing or not providing additional psychiatric case management services to substance abusers with depression in terms of: a) substance-related and non-substance-related psychiatric diagnoses and treatment services; and b) subsequent substance use, psychiatric severity and HIV risk behaviors at follow-up. The programmatic aims are: 3) to increase the visibility of drug abuse research within the Washington University environment by providing support to bring nationally recognized leaders in drug abuse research to give lectures to the Department and to consult with Dr. Compton and others in the Department of Psychiatry; and 4) to increase the number of trainees choosing a career in drug abuse research by providing a stimulating environment for study.